Knife bar for surgical instrument

ABSTRACT

A surgical instrument for surgically joining tissue includes a handle assembly, an elongate member extending distally from the handle assembly, an end effector disposed adjacent a distal portion of the elongate member, and an actuation assembly operatively associated with the handle assembly. The actuation mechanism includes a thrust bar disposed at least partially within the elongate member and a distal slide member. The thrust bar has a proximal portion, a distal portion, a first lateral side and a second lateral side and is configured to move between proximal and distal positions with respect to the handle assembly. The distal slide member is positioned adjacent the first lateral side of the thrust bar and is adjacent the distal portion of the thrust bar. The proximal portion of the distal slide member is adapted to slide relative to the thrust bar when thrust bar moves in a curvilinear direction.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.14/133,888, filed Dec. 19, 2013, which is a continuation of U.S. patentapplication Ser. No. 12/235,767 filed Sep. 23, 2008, now U.S. Pat. No.8,628,544, the entire contents of which are incorporated herein byreference.

BACKGROUND

Technical Filed

The present disclosure relates generally to surgical instruments and,more specifically, to surgical instruments for surgically joiningtissue.

Background of Related Art

Surgical stapling instruments used for applying parallel rows of staplesthrough compressed living tissue are well known in the art. Thesesurgical instruments are commonly employed for closing tissue or organsprior to transaction or resection, for occluding organs in thoracic andabdominal procedures, and for fastening tissue in anastomoses.

Typically, such surgical stapling instruments include an anvil assembly,a cartridge assembly for supporting an array of surgical staples, anapproximation mechanism for approximating the anvil and cartridge andanvil assemblies, and a firing mechanism for ejecting the surgicalstaples from the cartridge assembly.

In use, a surgeon generally initially approximates the anvil andcartridge members. Next, the surgeon can fire the instrument to placestaples in tissue. Additionally, the surgeon may use the same instrumentor a separate to cut the tissue adjacent or between the row(s) ofstaples. Alternatively, the surgical stapling instrument cansequentially eject the staples while the anvil approximates thecartridge.

SUMMARY

The present disclosure relates to a surgical instrument for surgicallyjoining tissue. Generally, this surgical instrument includes a handleassembly, an elongate member extending distally from the handleassembly, an end effector (e.g., having a curved shape) disposedadjacent a distal portion of the elongate member, and an actuationassembly operatively associated with the handle assembly. The actuationmechanism includes a thrust bar disposed at least partially within theelongate member and a distal slide member. The thrust bar has a proximalportion, a distal portion, a first lateral side and a second lateralside and is configured to move between proximal and distal positionswith respect to the handle assembly. The distal slide member ispositioned adjacent the first lateral side of the thrust bar and isadjacent the distal portion of the thrust bar. The proximal portion ofthe distal slide member is adapted to slide relative to the thrust barwhen thrust bar moves in a curvilinear direction.

In certain embodiments, the proximal portion of the thrust bar extendsproximally beyond a proximal-most end of the distal slide member.

The surgical instrument may further include a proximal slide memberpositioned adjacent the first lateral side of the thrust bar. In someembodiments, a distal portion of the proximal slide member is rigidlyaffixed to the thrust bar. In various embodiments, a distal-most end ofthe proximal slide member is positioned proximally of a proximal-mostend of the thrust bar.

The surgical instrument may further include an actuation mechanismdisposed in mechanical cooperation with the thrust bar and the handleassembly. The actuation mechanism is configured to move the thrust barbetween the proximal and distal positions upon actuation of the handleassembly.

In addition, the surgical instrument may include a knife operativelycoupled to the distal end portion of the thrust bar. The knife movesbetween a proximal position and a distal position in response to atranslation of the thrust bar.

The surgical instrument may further include a second distal slide memberpositioned adjacent the second lateral side of the thrust bar.

Moreover, the surgical instrument may further include a second proximalslide member positioned adjacent the second lateral side of the thrustbar.

The present disclosure further relates to an actuation assembly for usewith a surgical instrument. Briefly, the actuation assembly includes athrust bar including a proximal portion, a distal portion, a firstlateral side and a second lateral side and is configured to move betweenproximal and distal positions with respect to a handle assembly of thesurgical instrument. The distal slide member is positioned adjacent thefirst lateral side of the thrust bar and is adjacent the distal portionof the thrust bar. The proximal portion of the distal slide member isadapted to slide relative to the thrust bar when thrust bar moves in acurvilinear direction.

In some embodiments, the proximal portion of the thrust bar extendsproximally beyond a proximal-most end of the distal slide member.

The actuation assembly may further include a proximal slide memberpositioned adjacent the first lateral side of the thrust bar. In variousembodiments, a distal portion of the proximal slide member is rigidlyaffixed to the thrust bar. In several embodiments, a distal-most end ofproximal slide member is positioned proximally of a proximal-most end ofthe thrust bar.

The actuation assembly may further include a knife operatively coupledto the distal end portion of the thrust bar. The knife moves between aproximal position and a distal position in response to a translation ofthe thrust bar.

The actuation assembly may further include a second distal slide memberpositioned adjacent the second lateral side of the thrust bar. Inaddition, the actuation assembly may include a second proximal slidemember positioned adjacent the second lateral side of the thrust bar.

The actuation assembly may further include knife attached to the distalportion of the thrust bar.

BRIEF DESCRIPTION OF FIGURES

Various embodiments of the presently disclosed surgical instrument aredisclosed herein with reference to the drawings, wherein:

FIG. 1 is a perspective view of an embodiment of the surgical instrumentof the present disclosure;

FIG. 2 is a perspective view of an actuation assembly of the surgicalinstrument of FIG. 1;

FIG. 3 is a perspective enlarged view of a proximal portion of theactuation assembly of FIG. 2;

FIG. 4 is a perspective exploded view of the actuation assembly of FIGS.2 and 3; and

FIGS. 5-6 are top views of the actuation assembly of FIGS. 2-4, shown atdifferent stages of operation.

DETAILED DESCRIPTION

Embodiments of the presently disclosed surgical instrument are describedin detail with reference to the drawings, wherein like referencenumerals designate similar or identical elements in each of the severalviews. In the drawings and the description that follows, the term“proximal” refers to the end of the surgical instrument that is closestto the operator, whereas the term “distal” refers to the end of thesurgical instrument that is farthest from the operator. As appreciatedby one skilled in the art, the depicted surgical instrument firesstaples, but it may be adapted to fire any other suitable fastener suchas clips and two-part fasteners. Additionally, the disclosed actuationassembly may be used with an electrosurgical forceps. Further details ofelectrosurgical forceps are described in commonly-owned patentapplication Ser. No. 10/369,894, filed on Feb. 20, 2003, entitled VESSELSEALER AND DIVIDER AND METHOD OF MANUFACTURING THE SAME, the entirecontents of which are hereby incorporated by reference herein.

With reference to FIG. 1, reference numeral 100 designates an embodimentof the presently disclosed surgical instrument. In the interest ofbrevity, the present disclosure focuses on an actuation assembly ofsurgical instrument 100. U.S. Patent Applications Publication Nos.2008/0105730, filed on Nov. 28, 2007; 2008/0110960, flied on Jan. 8,2008; 2008/0142565, filed on Jan. 24, 2008; 2008/0041916, filed on Oct.15, 2007; 2007/0187456, filed on Apr. 10, 2007; U.S. Provisional PatentApplication Ser. Nos. 61/050,273, filed on May 5, 2008; and U.S. Pat.Nos. 7,407,076 and 7,097,089 describe in detail the structure andoperation of other surgical fastening assemblies. The entire contents ofthese prior applications and issued patents are incorporated herein byreference. Any of the surgical instruments disclosed in the cited patentapplications may include the presently disclosed actuation assembly.

Surgical instrument 100 is configured to clamp, fasten, and/or cuttissue. In general, surgical instrument 100 includes a handle assembly160, an elongate portion 120 extending distally from handle assembly 160and defining a longitudinal axis “A-A,” and a tool assembly 150 adaptedto clamp, cut, and join tissue. Elongate portion 120 has a proximalportion 122 and a distal portion 124 and operatively couples handleassembly 160 with tool assembly 150. In one embodiment, elongate portion120 is made of a flexible material capable of bending. During use, auser can bend elongate portion 120 to reach the target tissue. Toolassembly 150 includes end effector 154, which may be configured toarticulate relative to longitudinal axis A-A upon actuation of anarticulation knob 166. It is envisioned that any other mechanism ormeans may be utilized to articulate end effector 154. End effector 154,which is disposed adjacent distal portion 124 of elongated portion 120,includes a first jaw member 130 and a second jaw member 140. First andsecond jaw members 130, 140 have has a curved shape with respect tolongitudinal axis A-A. It is envisioned that curved jaw members mayfacilitate performing certain types of surgical procedures. For example,curved jaw members, as compared to straight jaw members (such as the jawmembers illustrated in FIG. 1), may help facilitate access to lowerpelvis regions, e.g., during lower anterior resection (“LAR”). At leastone of the jaw members 130, 140 is adapted to move relative to the otherjaw member (130 or 140) between spaced and approximated positions, e.g.,upon actuation of handle assembly 160. However, it is also envisionedthat other methods of approximating the jaw members are also usable,including sliding a clamp bar 168. In the illustrated embodiment, firstjaw member 130 contains a cartridge assembly 132, while second jawmember 140 includes an anvil assembly 142.

Handle assembly 160 includes a stationary handle 162 and a movablehandle 164. Movable handle 164 is adapted to move pivotally toward oraway from stationary handle 162. Further, movable handle 164 isoperatively connected to a jaw member (e.g., second jaw member 140)through a mechanism adapted to convert at least a partial actuation ofmovable handle 164 into a pivoting motion of at least one of cartridgeassembly 132 and anvil assembly 142 between spaced and approximatedpositions. As recognized by one skilled in the art, any conventionalactuation mechanism may be employed to operatively couple movable handle164 to tool assembly 150.

Cartridge assembly 132 has a tissue-contacting surface 134 and aplurality of fastener retaining slots 136. Tissue-contacting surface 134generally faces anvil assembly 142 and, during operation, engages tissuewhen the anvil assembly 142 is approximated with cartridge assembly 132.Fastener retaining slots 136 are arranged in rows along tissuecontacting surface 134. Each fastener retaining slot 136 is adapted tohold a fastener (not shown) until a user actuates handle assembly 160(see FIG. 1), for example. In an envisioned embodiment, when movablehandle 164 is pivoted toward stationary handle 162, the fasteners areejected from fastener retaining slots 134 and move toward anvil assembly142.

In addition to fastener retaining slots 134, cartridge assembly 132 hasa knife channel 138 adapted to slidably receive a knife 192 (see FIG. 2)or any other suitable cutting tool such as a blade. Knife channel 138 isdisposed between rows of fastener retaining slots 136 and extends alongtissue-contacting surface 134. In operation, knife 192 slides throughknife channel 138, e.g. in response to movable handle 164 pivotingtoward stationary handle 162. Alternatively, other mechanisms can beused to drive knife 192 through knife channel 138.

Referring to FIGS. 2-3, reference numeral 180 designates an actuationassembly for driving knife assembly 190 along knife channel 138. Knifeassembly 190 is coupled to a distal portion 184 of actuation assembly180 and includes a knife mount 194, which supports a blade or knife 192.At least a portion of actuation assembly 180 is made of a flexiblematerial capable of bending. In operation, knife 192 is distallytranslatable between first and second jaw members 130, 140 (e.g., tosever tissue) as actuation assembly 108 moves distally. When actuationassembly 180 moves distally (e.g., in response to an actuation of handleassembly 160 or a distal motion of clamp bar 168), knife 192 translatesalong knife channel 138.

Actuation assembly 180 is operatively associated with handle assembly160 and includes a thrust bar 200, a first distal slide member 220, asecond distal slide member 240, a first proximal slide member 260, and asecond proximal slide member 280. Thrust bar 200 is disposed at leastpartially within elongate member 120 (see FIG. 1) and has a proximalportion 202, a distal portion 204, a first lateral side 206, and asecond lateral side 208 (see FIG. 4). Knife assembly 190 is configuredto engage distal portion 204 of thrust bar 200. In addition, thrust bar200 is configured to move along with knife assembly 190 between proximaland distal positions with respect to handle assembly 160 upon actuationof handle assembly 160, for instance.

First distal slide member 220 has proximal and distal portions 222, 224,respectively, and is positioned adjacent first lateral side 206 ofthrust bar 200. Distal portion 224 of first distal slide member 220 isfixed adjacent distal portion 204 of thrust bar 200 such as by exampleon or more spot welds. This attachment can be made using adhesives,molding, welding, spot-welding or other methods. Proximal portion 222 offirst distal slide member 220 is adapted to slide relative to thrust bar200 when a portion of thrust bar 200 moves in a curvilinear direction(e.g., through an articulated joint, around a curved jaw member, etc.),as seen in FIG. 6. Proximal portion 202 of thrust bar 200 extendsproximally beyond a proximal-most end 226 of first slide member 220.

Second distal slide member 240 has proximal and distal portions 242, 244and is positioned adjacent second lateral side 208 of thrust bar 200.Distal portion 244 of second distal slide member 240 is fixed adjacentdistal portion 204 of thrust bar 200. Proximal portion 242 of seconddistal slide member 240 is adapted to slide relative to thrust bar 200when a portion of thrust bar 200 moves in a curvilinear direction, asshown in FIG. 6. Proximal portion 202 of thrust bar 200 extendsproximally beyond a proximal-most end 246 of second distal slide member240.

First proximal slide member 260 has proximal portion 262 and distalportion 264. Distal portion 264 of first proximal slide member 260 isrigidly affixed to proximal portion 202 of thrust bar 200 and adjacentfirst lateral side 206 of thrust bar 200. A distal-most end 268 of firstproximal slide member 260 is positioned distally of proximal-most end210 of thrust bar 200 and rigidly attached to thrust bar 200. Theattachment can be made using adhesive, molding, welding, spot-weldingand other methods. Proximal portion 262 of first proximal slide member260 is not affixed to proximal-most end 210 of thrust bar 200.

Second proximal slide member 280 has proximal portion 282 and distalportion 284. Distal portion 284 of second proximal slide member 280 isrigidly affixed to proximal portion 202 of thrust bar 200 and adjacentsecond lateral side 208 of thrust bar 200. This attachment can be madeusing adhesives, molding, welding, spot-welding or other methods. Adistal-most end 288 of second proximal slide member 280 is positioneddistally of proximal-most end 210 of thrust bar 200. Proximal portion282 of second slide member 280 is not attached to proximal-most end 210of thrust bar 200. Referring to FIGS. 5 and 6, a user employs surgicalinstrument 100 to join and/or cut tissue during operation. Initially,the user locates the target tissue and places said target tissue betweenfirst and second jaw members 130, 140. To place the target tissuebetween first and second jaw members 130, 140, the user might need toarticulate end effector 154 with respect to longitudinal axis A-A bymoving articulation knob 166 in the desired direction. In such case, endeffector 154 defines an oblique angle relative to longitudinal axis A-A.Also, the user can bend elongate portion 120 relative to longitudinalaxis A-A to reach the target tissue with end effector 154. In any case,at least a portion of actuation assembly 180 is capable of bending tomirror the path of the elongate portion 120 and end effector 124.

Once the target tissue has been positioned between first and second jawmembers 130, 140, the users pivots movable handle 164 toward stationaryhandle 162 or slides clamp bar in a distal direction to drive actuationassembly 180 distally and to move first and second jaw members 130, 140from a spaced position to an approximated position. In the approximatedposition, first and second jaw members 130, 140 capture the targettissue therebetween.

In use, when elongate portion 120 has not been bent, end effector 154has not been articulated, and jaw members 130, 140 are in-line withlongitudinal axis “A-A,” then actuation assembly 180 moves distally andnone of the slide members 220, 240, 260, 280 slide relative to thrustbar 280. That is, slide members 220, 240, 260, 280 move distally alongwith thrust bar 200 when the elongate portion 120 and end effector 154are oriented substantially parallel to the longitudinal axis A-A, asseen in FIG. 5.

In use, when elongate portion 120 has been bent, end effector 154 hasbeen articulated with respect to longitudinal axis “A-A,” or jaw members130, 140 are curved with respect to longitudinal axis “A-A,” a portionof actuation assembly 180 flexes and follows the path of elongateportion 120 and end effector 154. Specifically, proximal portions 222,242 of first and second distal slide members 220, 240, respectively,slide relative to thrust bar 200, as thrust bar 200 moves in acurvilinear direction, as shown in FIG. 6. Actuation assembly 180 isconfined within elongate portion 120 so as to inhibit first and seconddistal slide members 220, 240, respectively, from separating from thrustbar 200 while actuation assembly advances in a curvilinear direction.While moving actuation assembly 180 along a curved path, distal portions224, 244 of first and second distal slide members 220, 240,respectively, remain rigidly attached to distal portion 204 of thrustbar 200 and do not slide relative to thrust bar 200. Further, a portionof proximal slide members 260, 280 remain fixed to proximal portion 202of thrust bar 200 and do not slide relative to thrust bar 200 whenactuation assembly is moving in curvilinear direction. The slidingmotion of first and second distal slide members 220, 240 with respect tothrust bar 200 reduces the stress on actuation assembly 180 whenactuation assembly moves in a curvilinear direction. That is, less forceis required to advance actuation assembly 180 in a curvilineardirection. Regardless of whether actuation assembly 180 moves along acurved path or a straight line, actuation assembly 180 drives knifeassembly 190 distally upon actuation of handle assembly 160. As knifeassembly 190 moves distally toward the target tissue, knife 192 movesalong knife channel 138 and cuts tissue captured between first andsecond jaw members 130, 140.

It will be understood that various modifications may be made to theembodiments of the presently disclosed surgical instruments. Therefore,the above description should not be construed as limiting, but merely asexemplifications of embodiments. Those skilled in the art will envisionother modifications within the scope and spirit of the presentdisclosure.

What is claimed is:
 1. An actuation assembly for a surgical instrument,comprising: a thrust bar; a knife assembly directly coupled to a distalend portion of the thrust bar, the knife assembly having an upperengagement portion and a lower engagement portion; a proximal slidemember positioned adjacent a first lateral side of the thrust bar, aportion of the proximal slide member affixed to the thrust bar; and adistal slide member in contact with the thrust bar, a first portion ofthe distal slide member affixed to a first portion of the thrust bar,the first portion of the distal slide member fixed from longitudinalmovement with respect to the first portion of the thrust bar, and acenter of the distal slide member slidable with respect to the thrustbar.
 2. The actuation assembly according to claim 1, wherein a proximalportion of the thrust bar extends proximally beyond a proximal-most endof the distal slide member.
 3. The actuation assembly according to claim1, wherein the knife assembly is coupled to the distal slide member. 4.The actuation assembly according to claim 1, wherein the upper portionand the lower portion of the knife assembly extend in a lateraldirection.
 5. The actuation assembly according to claim 1, wherein thedistal slide member is directly affixed to the first portion of thethrust bar.
 6. The actuation assembly according to claim 1, wherein aproximal portion of the distal slide member is configured to sliderelative to the thrust bar when the thrust bar moves in a curvilineardirection.
 7. The actuation assembly according to claim 1, furthercomprising a second distal slide member in contact with the thrust bar.8. The actuation assembly according to claim 1, wherein a distal portionof the proximal slide member is affixed to the thrust bar, and whereinthe distal portion of the proximal slide member is limited to adistal-most quarter of the proximal slide member.
 9. The actuationassembly according to claim 1, wherein the first portion of the distalslide member is on a distal portion of the distal slide member.
 10. Theactuation assembly according to claim 1, wherein the knife assemblymoves with the thrust bar.
 11. The actuation assembly according to claim1, wherein the thrust bar includes a longer length than a length of thedistal slide member.
 12. The actuation assembly according to claim 1,wherein a center of the proximal slide member is slidable with respectto the thrust bar.
 13. The actuation assembly according to claim 1,wherein a proximal half of the distal slide member is slidable withrespect to the thrust bar.
 14. An actuation assembly for a surgicalinstrument, comprising: a thrust bar; a knife assembly directly coupledto a distal end portion of the thrust bar; a proximal slide memberpositioned adjacent a first lateral side of the thrust bar; a firstdistal slide member positioned in contact with a first portion of thethrust bar, a distal portion of the first distal slide member beingfixed from longitudinal movement with respect to the first portion ofthe thrust bar, a center of the first distal slide member being slidablewith respect to the thrust bar; and a second distal slide memberpositioned in contact with the thrust bar, the thrust bar having alonger length than a length of each of the first distal slide member andthe second distal slide member.
 15. The actuation assembly according toclaim 14, wherein a distal portion of the proximal slide member isrigidly affixed to the thrust bar, and wherein the distal portion of theproximal slide member is limited to a distal-most quarter of theproximal slide member.
 16. The actuation assembly according to claim 14,wherein the first distal slide member is fixed to the first portion ofthe thrust bar adjacent a distal portion of the thrust bar.
 17. Theactuation assembly according to claim 14, wherein the knife assemblymoves with the thrust bar.
 18. The actuation assembly according to claim14, wherein the proximal portion of the first distal slide member isconfigured to slide relative to the thrust bar when the thrust bar movesin a curvilinear direction.
 19. The actuation assembly according toclaim 14, wherein both of the first distal slide member and the seconddistal slide member are positioned in direct contact with the thrustbar.
 20. The actuation assembly according to claim 14, wherein aproximal half of the first distal slide member is slidable with respectto the thrust bar.